February 06, 2019
2 min read

Adults with thyroid disease lack knowledge of ophthalmologic threats

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Adults with thyroid eye disease or Graves’ disease without orbitopathy have greater understanding of thyroid eye disease than the general population, but still exhibit some knowledge gaps, according to findings published in Thyroid.

“Previous studies have demonstrated that increased patient knowledge of a disease results in earlier presentation to health services, better insight into that condition, reduced anxiety and increased compliance with treatment,” wrote Matthew R. Edmunds, PhD, MRCP, FRCOphth, of the academic unit of ophthalmology at the University of Birmingham, and the Birmingham and Midland Eye Centre of City Hospital in Birmingham, U.K., and Kristien Boelaert, PhD, FRCP, of the Institute of Metabolism and Systems Research, University of Birmingham. “This is especially important in thyroid eye disease, an inflammatory condition of the orbital tissues which occurs in around 25% of those with the autoimmune hyperthyroidism, Graves’ disease.”

To assess knowledge of thyroid eye disease, Edmunds and Boelaert consecutively enrolled 100 adults with thyroid eye disease, 100 adults with Graves’ disease and 100 adults with neither condition from the Thyroid Clinic of University Hospital Birmingham and the Orbital Diseases Clinic of Birmingham and Midland Eye Centre. All participants were age- and sex-matched and completed an anonymized questionnaire to identify demographics, disease status and disease knowledge. Part of the questionnaire included 20 true or false questions to evaluate knowledge of thyroid eye disease. Participants were then given a “knowledge score” based on a 1 to 20 scale.

Participants with thyroid eye disease had a higher median knowledge score (14.25) than participants with Graves’ disease (13.71). However, the researchers noted that this difference was not significant. Knowledge scores did not differ significantly based on age, sex, ethnicity, level of education, language, disease duration or duration of follow-up.

Both groups had higher median scores than those with neither condition (11.53; P < .001), although the researchers noticed a few knowledge gaps. These included knowing whether thyroid eye disease occurs only in hyperthyroidism, smoking’s association with the disease and surgical management.

“Despite time and resource limitations, we as physicians still have responsibility for ensuring that we appropriately counsel our patients regarding important aspects of [Graves’ disease] with and without orbitopathy,” the researchers wrote. “The answers given by [Graves’ disease] and [thyroid eye disease] patients in this study demonstrate a number of misconceptions that endocrinologists and ophthalmologists need to be aware of and try to overcome. Our findings indicate the need to tailor educational efforts and materials to deficient areas and to focus on important aspects of [thyroid eye disease] knowledge with the aim of dispelling misconceptions.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.